Search

The number of children born through gamete donation grows by the conceptions made abroad. All the couples engaging in this process do not benefit from of the same support around the issues raised by the information to the child and its terms. Through a literature review, the authors explore the data on information intentions from parents to child and to entourage, the influence of the issue of anonymity, the effective rate information, the influences of the age of the child, the terms information and links with family dynamics. The quantitative findings underscore the complexity of this task, since 10-90 % of couples report an intention to inform their child from conception through donation, while 5-30 % actually inform them after birth. Fifty-nine to 93 % of the relatives are nevertheless informed. The authors will highlight the psychopathological tracks that support the possibility of narration for parents: the internalization of their infertility, the representation of the gift, the development of rivalry towards donors, the secrecy and privacy. The objective of this article is to enable carers to accompany this reflection among future parents, a better listening of the issues raise by the couples allowing shoring their process., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Background: A pilot study from our group suggests that the prevalence of chronic obstructive pulmonary disease (COPD) among dairy farmers is higher than in the general population although dairy workers are less frequently smokers., Objectives and Methods: The study presented here aims at (i) determining the prevalence of COPD in a large and representative population of dairy farmers; (ii) characterizing these patients in terms of smoking habits, dyspnoea, quality of life, lung function, bronchial exhaled nitric oxide, systemic inflammation, arterial stiffness and exercise capacity; (iii) comparing characteristics of dairy farmers' COPD with the characteristics of COPD in patients without any occupational exposure; (iv) identifying the etiological factors of COPD in dairy farmers; and (v) constituting a cohort of COPD patients and control subjects for further longitudinal studies. Two groups of COPD patients (dairy farmers or not) and two groups of controls subjects will be selected among a representative panel of 2000 dairy workers and 2000 subjects without any occupational exposure, all aged 40 to 75 years., Expected Results: A better knowledge of the epidemiology and pathophysiology of COPD in dairy farmers should guide a specific strategy of prevention. The knowledge of the characteristics of COPD occurring in dairy farmers will help to define the therapeutic modalities that might be different compared with the therapeutic recommendations for COPD secondary to tobacco smoking., (Copyright © 2012 SPLF. Published by Elsevier Masson SAS. All rights reserved.)

There are two leukocytospermia: the leukocytospermia below 10(6) cells/ml comes from the epididymis. It is physiological, improves sperm quality and ART outcomes and therefore must be respected. Leukocytospermia above 10(6) cells/ml are of prostatic origin and reflect a chronic prostatitis. The results of IVF and ICSI with these sperm are always surprisingly improved when compared to those obtained using semen without leukocytes at all. But this improvement is offset by a dramatic increase in the miscarriage rate. Should we treat this leukocytospermia or its cause? A clinical trial is conducted in Cochin hospital with the PHRC Sigma (Male Genital Track Inflammatory Syndrome) that will help us answer this question. It seems, a priori, that it is better to treat the cause and to respect the leukospermia., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

Assessment of male infertility includes clinical examination, laboratory tests (semen analysis, hormones dosage) and sonographic examination of the urogenital tract. Male infertility is due to testicular abnormalities (secretory type) or obstructive disorder (excretory type). Imaging should provide accurate definition of anatomical causes of infertility in order to deliver appropriate treatment. Testicular Doppler ultrasound with transrectal ultrasound is the gold standard imaging technique to explore male infertility. MRI, because of its high resolution, provides a multiplanar study especially in congenital and inflammatory abnormalities of the urogenital tract. This pictorial review illustrates the most frequent causes of male infertility., (Copyright © 2012. Published by Elsevier SAS.)

Objective: To analyze the effectiveness of pre-washing the intrauterine insemination catheters on IUI outcome., Patients and Methods: Infertile couples (n=322) involved in a IUI program were included in the study. IUI indications were cervical factors, ovulation dysfunction, cryopreserved semen and unexplained infertility. Every other week for two years, IUI catheters were washed with culture medium prior to intrauterine sperm insemination., Result(s): Only the first IUI for each couple were analyzed. Washing the catheter, prior to use, resulted in a 49.7% increase in clinical pregnancy rate (22.0% vs 14.7% P<0.05). This result is observed with fresh sperm (15.7% vs 11.1%) and frozen-thawed sperm as well (31.1% vs 19.8%). The early pregnancy termination rate was similar in all groups., Discussion and Conclusion: Pre-washing the catheter before IUI should be recommended in Good Laboratory Practice Guidelines as it is already the case for embryo transfer catheters. This raises the problem of washing all single-use devices, in contact with gametes or embryos during IVF., (Copyright © 2012. Published by Elsevier SAS.)

Mammalian sperm migrate over long distances through the female genital tract before reaching the oviduct where fertilization occurs. This process is more complex than predicted by the movement of sperm. The oviduct is composed of three major segments: the uterotubal junction, the isthmus and the ampulla. These structures appear to play roles for the success of fertilization. Gene knockout approaches of several genes in mice suggest that the migration of spermatozoa in the oviduct is regulated to allow competent gametes encounter ensuring the success of fertilization with minimum risk of polyspermy. The sperm of male mice deleted for following genes: Calmegin, Calsperin, Angiotensin-Converting-Enzyme, Adam1a, Adam2 or Adam3 are morphologically normal and motile, but not able to pass through the uterotubal junction. The precise mechanism of how these molecules facilitate the passage of spermatozoa through the uterotubal junction is still unknown, but Adam3 seems to be the major factor in this process since it is implicated in these six lines of mutant mice., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)

Objectives: To evaluate the ART results with sperm donation for couples who do not succeed after IC ICSI treatment for male infertility., Patients and Methods: Retrospective study of 71 couples (November 1994-February 2009). Two control populations were determined to analyse this two-steps treatment (IC and sperm donation) based on different criteria such as the date of ICSI, the female age at the time of the first attempt and the male indication., Results: In IC-ICSI, the proportion of azoospermic subjects and/or carrying chromosomal abnormalities was significantly higher in the studied population as compared to control. The fertilization rate (FR) and the embryo quality were significantly lower in the studied population. After donation, 30 couples (42.2%) succeeded in being parents. The donor IA pregnancy rates were similar to those of the control population except for the azoospermic patients with poor results. When IVF/ICSI-D was performed, the pregnancy rates were lower than in the control population., Discussion and Conclusion: Sperm donation constitutes an option for half of the couples initially treated with IC-ICSI for male infertility. For couples who failed in sperm donation, a female implication cannot be excluded, even though not detected., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)

Objectives: Thresholds of sperm parameters associated with intrauterine insemination (IUI) success are controversial. This entails heterogeneous practices and leads to low success rate (approximately 8% per attempt). The aim of this study was to evaluate the influence of sperm parameters on the outcome of IUI., Patients and Methods: This study included 248 cycles of IUI. Parameters of the raw and selected sperm, as well as the main female characteristics, have been prospectively tabulated and compared, according to the presence or not of a clinical pregnancy., Results: In all, 28 clinical pregnancies were obtained (11.3% per cycle). Thresholds of 10% for the forward motility "a" in the whole sperm and of 20% for the percentage of typical spermatozoa in the selected sperm were related to the success of IUI. The number of motile inseminated spermatozoa, concentration and overall motility of sperm, determined before or after selection, did not have any significant influence on the outcome of IUI., Discussion and Conclusion: Thresholds determined in our study should help to optimize the use of IUI.

Objectives: Since we observed in our laboratory a significant decrease of the fertilization rate in the classical IVF procedure compared to ICSI, we wanted to evaluate a new insemination procedure, using sperm morphology of selected semen as a criterion taken into account to calculate the number of mobile sperm to inseminate., Patients and Methods: Therefore, we designed a prospective autocontrolled study which took place from September 2006 to May 2007. All IVF attempts resulting from infertile couples were included in the study if a previous analysis (lesser than one year) of sperm parameters performed in our laboratory was assessed as normal. The retrieved oocytes were separated into two groups (sibling ovocytes), inseminated randomly either with the usual procedure (control group) or with the tested protocol (tested group). Fertilization rate was the primary end point to evaluate this assay. Polyspermy rates were also compared. Subsequently, embryonic quality and development were assessed to eliminate an oxidative stress impact. Paired Student t-test was applied for statistical analysis., Results: In all, 130 couples were included. The diploid fertilization rate was significantly increased in the tested group compared to the control group (66.9% vs 61.3%; p=0.017). No statistically significant difference was showed between the polyspermy rate and numbers of (i) good quality embryos and (ii) blastomeres per embryo into the two groups., Discussion and Conclusion: Compared with the conventional insemination procedure, the fertilization rate benefited from the tested insemination method in our laboratory without damaging embryonic growth. In the limit of our procedure, selected sperm morphology should be used to inseminate an appropriate number of spermatozoa within oocytes, even in case of normal semen values.

Objective: Multiple embryo transfer is responsible for a high rate of multiple pregnancies (ICSI), with subsequent risks of premature birth and perinatal death. This prospective non randomized study aimed to assess the ability of an elective single-embryo transfer (eSET) policy to reduce the twin pregnancy rate, compared to a double embryo transfer (DET) approach., Patients and Methods: Between March 2005 and May 2006, 180 eligible women were proposed to benefit from an eSET transfer rather than a DET. Inclusion criteria were (i) age less than 37 years old; (ii) at least two good quality embryos available (three to five cells at day 2 or six to nine cells at day 3; less than 20% fragmentation and the absence of multinucleates blastomeres), after IVF or ICSI and (iii) no more than one previous failed treatment cycle. Outcome analysis included cycles with frozen-thawed embryo transfer (FET)., Results: According to patients' decision, 107 and 73 women had an eSET (59.4%) and a DET (40.6%) respectively. No differences were found between eSET and DET groups regarding demographics and biologicals parameters. The clinical pregnancy rate (PR) per transfer was 43.9% in eSET group and 57.5% in DET group (p=0.07). The twin pregnancy rates were 0 and 14.3%, in eSET and DET groups, respectively (p=0.007). The cumulative PR per patient, including the outcome of performed FET cycles, was 63.6% in eSET group and 61.6% in DET group. In this case, the cumulative twin pregnancy rates were 2.9 and 15.6% in eSET and DET groups, respectively (p=0.02)., Discussion and Conclusion: Our data show that in a selected population of women, transferring one fresh embryo and then, if required, one or two frozen-thawed embryos significantly reduces the twin pregnancy rate without decreasing the overall pregnancy rate. This study supports the policy of eSET in this subgroup of patients.

Ovarian hyperstimulation syndrome is a iatrogenic complication that could happen during ovulation induction. Metabolic modifications can lead to a third sector and organic failure. Medical treatment, undertaken in first line, may be insufficient. In these cases, invasive treatment, using surgical techniques, in association with reanimation principles becomes necessary. From the simple drainage to final measures for the patient's rescue, this review describes the different solutions and their respective place. Several means exist, but serious evaluation is lacking. Their use should be indicated specifically. Medico-surgical associations seemed to offer interesting results.

Leukocytospermia is frequent and significantly increased (over 10(6)/ml) in 20% of male factor infertility. It induces the production of highly toxic reactive oxygen species (ROS) which impair genital track accessory glands and sperm cell functions. The seminal medium contains extremely potent antioxidative defenses which usually balance the oxidative stress. In vivo, these defenses can be overwhelmed when ROS production is extremely important and/or when it lasts for a very long period of time. Infertility can then appear. In vitro, ROS have been univoqually demonstrated for being highly toxic since spermatozoa are no longer protected. Sperm cell defects are : decrease of acrosome reaction and fusiogenic ability and increase of DNA fragmentations. In case of male factor infertility, a leukocytospermia represents an essential or an additional risk factor that should be treated, specially when in vitro therapy is to be scheduled, in order to improve gamete quality.

Mature oocytes are rare and highly specialized cells. In vitro maturation of human oocytes is an emerging assisted reproductive technology allowing to produce more mature oocytes without ovarian stimulation. Whereas in vitro maturation is technically more demanding than conventional in vitro fertilization for the laboratory, it carries many potential advantages, for example, in terms of lower treatment heaviness and removal of risk of severe ovarian hyperstimulation syndrome for the patients. Although the technology is still experimental, oocytes in vitro maturation has been successfully used and pregnancies and live births have been reported. Despite these successes, the overall efficiency of in vitro maturation remains low and this procedure must still be improved. The different steps of in vitro maturation process are shown and discussed as well as results in terms of pregnancy and live birth rates.

We report a case of a renin secreting tumor, which is a very rare cause of secondary high blood pressure. A 22-year-old woman was hospitalised for exploration of high blood pressure (160/110 mmHg) with severe hypokaliemia (2,7 mmol/l) and secondary hyperaldosteronism. Physical examination was normal except the high blood pressure. Bioassays show increased kaliuresis (66 mmol/24h), plasma renin (89 pg/ml in clinostastism--108 pg/ml in orthostatism), pro-renin (1207 pg/ml in clinostastism--1412 pg/ml in orthostatism) and aldosterone (210 pg/ml in clinostastism--566 pg/ml in orthostatism). The rest of the endocrine tests were normal (cortisol and ACTH at 8:00 am, urinary free cortisol, overnight 1 mg dexamethasone suppression test). Doppler ultrasound method, performed by an experienced radiologist, did not show renal artery stenosis. Abdominal computerized tomography showed a nodular formation at the upper pole of the right kidney, isodense to renal medullary. The size tumor was 15 mm. The renal vein sampling shows high values of renin on both sides whereas, for the pro-renin, the values were higher on the tumor side. In spite of treatment with CEI (Converting Enzyme Inhibitors) and calcium antagonists, the blood pressure was not controlled. Hypokaliemia persisted (3 mmol/l) in spite of high daily potassium intake (64 mmol/l of potassium chloride). After tumor resection, reninoma was diagnosed by the pathology examination and blood pressure, plasma rennin, plasma aldosterone level returned to normal.

Objectives: This prospective study aimed to evaluate the impact of oocyte dysmorphy on the fertilization rate and embryonic development rate in an ICSI programme., Patients and Methods: Three hundred and two couples have been included during 302 ICSI cycles, and 1970 oocytes have been studied in 4 ART centres. After decoronisation, 18 morphological criteria, including the size and shape of the oocyte, the thickness of the zona pellucida, the presence or not of debris in the perivitelline space, as well as the appearance of the cytoplasm and polar body have been noted., Results: In total 61.3% of the oocytes presented a dysmorphy, involving, almost equally, the different oocyte compartments. Among the dysmorphic oocytes, half presented more than one anomaly. On average, 9.2% of the oocytes were lysed the day after the micro-injection. The oocytes presenting an enlarged perivitelline space, or multiple vacuoles had a significantly raised lyse rate, 16.3% and 27.8%, respectively. The day after micro-injection, 61.3% of the intact oocytes were fertilized. The rate of fertilization was correlated to the number of abnormalities per oocyte: 1 anomaly: 64.6%, > or = 3 anomalies: 54.6%. The oocytes presenting a large perivitelline space had a slightly lowered fertilization rate (53.4%). On the other hand, those showing a cytoplasm containing refractile bodies had a slightly raised fertilization rate (68.6%). We did not see any statistically significant difference between the different types of oocytes concerning embryonic development at d2., Conclusion: These results confirm and contribute new elements with respect to previously published data, showing that (i) oocyte morphology little affects fertilization and the first stages of embryonic development; (ii) certain dysmorphies, (enlargement of the perivitelline space) are specifically deleterious at certain stages in the process (lowering the fertilization rate); (iii) certain morphological differences (the presence of refringent bodies) are not anomalies, but can reflect physiological cellular changes.

Objectives: The objective of this study was to analyse all attempts of ICSI performed in our centre between 1995 and 1997 with surgically harvested sperm for the treatment of secretory and excretory azoospermia., Material and Methods: 71 infertile couples, in which the man suffered from secretory (n = 8) or excretory azoospermia (n = 63), were managed with 94 attempts of ICSI., Results: ICSI was able to be performed 85 times with 82 embryo transfers resulting in 29 clinical pregnancies. The clinical pregnancy rate per ICSI attempt was comparable with sperm obtained on the day of ICSI or previously harvested and frozen (30.5% and 31.4% respectively). The clinical pregnancy rate per ICSI attempt was 33.3% for testicular sperm (n = 18), and 30.3% for epididymal sperm (n = 76). Twenty-seven clinical pregnancies (32.1%) were obtained for men with excretory azoospermia (47.2% for vas deferens agenesis and 20.8% for acquired urinary tract obstruction, p = 0.01), and 2 (20%) for men with secretory azoospermia., Conclusion: ICSI can achieve pregnancy in infertile couples in whom no other solution can be considered. Cryopreservation allows surgical harvesting to be dissociated from ICSI without decreasing the pregnancy rate, justifying freezing of sperm during any surgical procedure on the seminal tract. The better results obtained in congenital excretory azoospermia compared to acquired obstructions, usually post-infectious, suggest a harmful effect of infection on the quality of sperm.

The pregnancy rate after ICSI with surgically retrieved spermatozoa varies according to the etiology and to the level of sperm retrieval in the genital tract. The use of testicular sperm in all cases is discussed.

Subzonal insemination was the first micromanipulation technique used in the treatment of male factor sterility. Analysis of the sperm pathology prior to patient inclusion in the program allowed us to study gamete interaction in the human and the early embryogenesis. A series of 523 cycles and 3,027 micro-injected oocytes is reported.

Human oocyte cytometry was studied during a program of Subzonal Insemination. Oocytes with a diameter over 108 microns presented higher fusiogenic ability than others. Independently of nuclear maturational criteria, the ooplasma growth appears as an important factor of oocyte maturity. Human oocyte plasma membrane protein pattern was assessed using biotinylation technique, western Blot and chemoluminescence (ECL) on 2 days old unfertilized oocytes. The total membrane protein content decreases dramatically from germinal vesicle to metaphase 2 stage oocytes with a relative over expression of the 71 kD. It represents 30% of the total protein content of the mature oocyte membrane. The protein profile, assessed on single oocytes, showed a polymorphism including for oocytes coming from the same cohort. Its functional importance is currently investigated.

After standard in vitro fertilization (IVF) chromosome analysis of uncleaved oocytes has shown that in about 80% of the cases, there was no fertilization at all while in 10% of the cases there was a premature chromosome condensation and a development arrest. After micro-injection our results suggest that both the technique itself and the pathologies which require micro-injection can influence the results. On the other hand about 20-30% of the metaphase II oocytes are cytogenetically abnormal after IVF attempt while ICSI might increase chromosome breakage. Our results suggest that both the technique used and the gamete pathologies can influence the different steps of development arrest.

A degree in surgical research has been set up in 1986 in France. It includes a one-year full time work in a research laboratory, and seminars (one to three days long, each). General surgical research objectives are gathered in a first seminar. Then, candidates select one among four optional subjects: biomaterials-artificial organs, transplantation, oncology, and neurosciences. Two prerequisites are necessary in order to register. The first is to write a research project according to standardized rules, and the second is to attend two seminars, one dealing with scientific communication and the other with methodology in clinical research. A nation-wide valid Academic degree is delivered to candidates who pass an oral presentation of their research report and who attended all seminars according to the optional subject that they selected. From 1986 to 1993, 434 students attended the formation. They came from different regions of France, proving the nation-wide characteristic of the degree, and some from foreign countries. Seminars were held in different French University towns. An increasing number of students become Ph.D.

Sperm motility is a key function in the process of fertilization. Significant gaps in the knowledge of the mechanisms of control and modulation of sperm motility still remain. It is well known that the percentage of motile sperm is correlated with fertility in vivo but the recent development of assisted reproductive technologies and the extensive use of objective methods to assess sperm movement in vitro indicate that the quality of sperm movement is important too for fertilization. However, the exact pattern of motility characteristics to fulfill fertilization in vitro and in vivo are not clearly established essentially because of the lack of multiparametric and controlled studies in vitro and prospective studies in vivo. There is also presently no evidence for an improvement of fertility when using different pharmacological approaches to increase sperm motility in vitro. Therefore, further efforts are required to improve our basic knowledge of the relations between sperm motility and fertility with the aim to adapt and apply it to the problem of male infertility.

Two methods of extraction, prior to radio-immunoassay (RIA) of human plasma arginine vasopressin (AVP) were tested: ethanol extraction (ETH), chromatography with ODS-Silica (ODS-Sil). Recovery of 125I AVP was higher when using ODS-Sil than when using ETH. Recovery of standard AVP and plasma enriched with standard AVP was found to be more efficient and reproducible for ODS-Sil. However, the RIA used, performed after chromatography with ODS-Sil, is not enough sensitive to detect low concentrations but is able to detect high concentrations and physiological variations of plasma AVP.

The authors have made a growth cure of the bi-parietal diameter of the African infant using observations taken on 350 African women who were followed up and delivered in their department. Over all these curves of growth are smaller than the reference curves used in France. This study is a first contribution to the understanding of the mechanics of obstetrics in the African woman.

6.9% of women involved in accidents are pregnant. It is difficult to calculate all the fetal and maternal lesions that occur under these conditions. We are reporting a case of a 27-year-old primipara who had internal bleeding with shock without a precise aetiology. Very heavy vaginal bleeding occurred on the third day after admission so that a Caesarean had to be carried out in order to preserve the health of the mother and of the baby. Several complications can follow road traffic accidents in pregnant woman. The worst is usually fetal death and its mechanism is discussed. More frequently occurring, however, are fetal distress that threaten premature labour. Some lesions that are not lethal, such as bone fractures, can affect the long-term outlook for the pregnancy.

Since angiosarcoma of the breast was first reported in 1907 fewer than one hundred cases have been reported. They are primary malignant vascular mesenchymal tumors occurring in young females. Their prognosis is very bad. We report here six new cases treated at the Institut Curie between 1972-1983. The mean age was 33, range 27-40. One tumor was a low grade one and the five others of breast, were high grade tumors. We carried out four amputations three associated with radiotherapy and/or chemotherapy and the fourth one did not received adjuvant treatment. In the two others cases the diagnosis was made when the patients were already suffering from polymetastatic disease. The mean survival was 17 months, the range 5-44 months. Recent reviews of the pathologic material made it possible to differentiate three grades in these tumors. The prognosis was correlated to the degree of differentiation. Recently hormonal receptors have been described in soft tissue sarcomas. The value of levels of these receptors in breast angiosarcoma Is discussed.

In trained subjects, circulating PRL and GH increase significantly after a 20 minutes exercise on ergometer bicycle performed either at submaximal or maximal intensity. The magnitude of PRL response appeared to be similar for both kinds of exercise, but the increase in GH level is higher after maximal exercise than after submaximal one.

The purpose of this study was to determine and to compare the frequency of hypercalciuria, hyperoxaluria and hyperuricosuria in 49 patients with a pure or mixed calcium oxalate urolithiasis. During this study, all patients were on a normal diet and had no special disease or medication. We noted that hypercalciuria (35%) and hyperoxaluria (24%) were more often associated (18%) than isolated (8 and 2%). They were more frequent in mixed stones (44% et 39%) than in pure one (29% and 16%). Hyperuricuria (39%) had a same frequency wathever the renal stone type may be. A same frequency was noted when hyperuricuria was associated with hypercalciuria and hyperoxaluria (12%) or isolated (14%). None of these three biologic disturbances was observed in 45% of our patients.

Bartter's syndrome, chondrocalcinosis and nephrogenic hypomagnesemia in an adult. Bartter's syndrome, chondrocalcinosis and nephrogenic hypomagnesemia in an adult. Bartter's syndrome, initially described in children, becomes a controversial entity when it is observed in adults, as it cannot be dissociated easily from the pseudo Bartter's syndrome caused by an abuse of diuretics or provoked by surreptitious vomiting. Yet its association with chondrocalcinosis, about ten cases of which have already been published and which is not reproducible by prolonged diuretic treatment, seems to give it some authenticity. The link between the two conditions might well be the low blood magnesium level observed significantly in both diseases and constantly when they are associated. This hypomagnesaemia is of renal origin and it may reflect a complex tubular disorder which also includes a defect of chloride reabsorption by the tubule. We report here a case of diffuse chondrocalcinosis and Bartter-like syndrome in a 38-year old woman, leading to the discovery of nephrogenic hypomagnesaemia.

An analysis of socio-professional categories was performed in 712 active hypertensive men, referred between January 1st 1976 and December 31st 1977 to the hypertension out patient clinic of the Saint-Joseph Hospital, Paris. The percentages of senior executives, middle executives and patients with liberal professions, were higher than those calculated in the whole French population. In contrast, the percentages of craftsmen, shopkeeper, employees and manual workers were lower. Furthermore, blood pressure levels obtained by history and those found at first consultation were higher in employees and manual workers than in patients from a higher socio-economic level. The social differencies which are observed may be related to known data concerning mortality, morbidity and drug consumption according to socio-professional categories. They should lead physicians and health care administrators to seek more effective and egalitarian methods of prevention.

A mental work (lecture) does not modified the normal decreased plasma prolactin rhythm in the morning. On the other hand the association of a psychic stress to a mental work (examination) induced a rise of plasma prolactin which pursues it course after the end of the examination.

In 94 normotensive subjects and free sodium diet, the relationship between SPRA and the 2-hour urinary sodium excretion was significantly better fitted by an hyperbolic function (p less than 0,001); r = 0,53) than a linear one (p less than 0,001; r = -0,31) between SPRA and the 24-hour urinary sodium excretion. (SPRA = Supine Plasma Renin Activity).

Serum and urinary glucose, creatinine, calcium and phosphorus, serum insulin were measured every 60 min from 9.00 to 12.00 in twenty healthy subjects. All subjects presented normal body weight, renal function, serum glucose, serum and urinary calcium. Urinary calcium and phosphorus were expressed by Ca/creat and P/creat ratio, and renal phosphate threshold was expressed by the TmP/GFR ratio. At 9.00, after an overnight fast, ten subjects received 75 g of glucose (groupe B) and ten subjects were conserved as controls (group A). Hyperglycemia and hyperinsulinemia due to glucose load (B) induce a decrease of serum phosphorus (10.00, 11.00, 12.00), while phosphoremia increased in group A. Urinary P/creat increased in group A (12.00), and decreased in group B (12.00); while TmP/GFR decreased in group B (10.00, 11.00). Serum calcium rose in the two groups, according to the circadian rythm and urinary Ca/creat ratio increased in group A (10.00) and increased considerably in group B (10.00, 11.00, 12.00). In group B, a negative linear correlation was found between serum glucose and TmP/GFR ratio (= -0,50) and between serum phosphorus and urinary Ca/creat ratio (r = -0,40). These results show that in healthy subjects, with normal body weight, oral glucose load induced a decrease of phosphaturia and an increase of calciuria, subsequent to hyperglycemia.